Conditions are less likely and suspension more likely because of the element of deception.
The case against Dr Q concerned two occasions of her purporting to have performed a lumbar puncture (“LP”) on patients when she had not. In respect of the first patient the facts were that Dr Q’s Educational Supervisor (“ES”) had asked her to undertake a LP, Dr Q had tried and failed to do so and so had another doctor supervise her. That doctor ultimately had to perform the LP and so asked Dr Q not to put her name on the records, Dr Q not only put her name on but did so first thereby intimating that she had carried out the procedure. Dr Q admitted the facts but gave evidence that she felt bullied by her ES. She gave evidence of her being ‘repeatedly and publicly criticised in front of colleagues … feeling bullied and harassed … acting out of fear”. Her evidence was supported by another colleague who gave evidence to the Tribunal confirming the atmosphere in the department. The Tribunal had regard to this as a relevant factor.
Two days after the first patient, Dr Q was endeavouring to perform a LP on a second patient when a Consultant noticed her encountering difficulties and so offered to help. The Consultant performed the LP but Dr Q failed to record their involvement in the clinical notes she later prepared. Dr Q explained that the only reason she had not fully noted the Consultant’s details was because she was embarrassed that she had forgotten his name and the following day she had made some unsuccessful enquiries and later became too busy dealing with other matters. The Tribunal accepted this and found that she was not dishonest.
In respect of both patients however the Tribunal held that it was serious misconduct and they found her fitness to practice was impaired.
By the time of the Tribunal hearing, more than two years after the index incidents, Dr Q was said to have substantial but not full insight and found it hard to say she was dishonest regarding the first patient. The risk of her repeating the misconduct was said to be very low and she was not an unsafe practitioner. The Tribunal were however mindful that she had mislead colleagues, good clinical notes are critical and whilst no patients were harmed such conduct could cause harm.
Dr Q’s counsel had sought to persuade the Tribunal that conditions could be workable on the facts of the case. She submitted that a Personal Development Plan, having a mentor and having her ES report to the GMC would be preferable to suspension. Taking a doctor out of practice during the pandemic, she argued, was not in the public interest and the proceedings themselves were sufficient reprimand. The Tribunal however noted the Sanctions Guidance and determined that despite the acknowledgment of fault, suspension was warranted. Dr Q was therefore suspended for two months without a review hearing as it was accepted she was otherwise safe to practice.
There are applicable parts of GMP which were cited in the judgement. Paragraphs 19 and 68 require records to be clear and accurate and paragraph 71 requires registrants do not leave out relevant information. You will appreciate each case turns on its own facts and if you have queries concerning your fitness to practise please contact us for direct advice.
